Abstract
Cord blood (CB) offers several unique advantages as a graft source for hematopoietic stem cell transplantation (HSCT). The risk of relapse and graft vs. host disease after cord blood transplantation (CBT) is lower than what is typically observed after other graft sources with a similar degree of human leukocyte antigen mismatch. Natural killer (NK) cells have a well-defined role in both innate and adaptive immunity and as the first lymphocytes to reconstitute after HSCT and CBT, and they play a significant role in protection against early relapse. In this article, we highlight the uses of CB NK cells in transplantation and adoptive immunotherapy. First, we will describe differences in the phenotype and functional characteristics of NK cells in CB as compared with peripheral blood. Then, we will review some of the obstacles we face in using resting CB NK cells for adoptive immunotherapy, and discuss methods to overcome them. We will review the current literature on killer-cell immunoglobulin-like receptors ligand mismatch and outcomes after CBT. Finally, we will touch on current strategies for the use of CB NK cells in cellular immunotherapy.
Highlights
Cord blood (CB) is a rich source of hematopoietic stem and progenitor cells and is being increasingly used as a graft source for hematopoietic stem cell transplantation (HSCT) [1]
In an elegant study performed by Joncker et al [119], adoptive transfer of mature functional Natural killer (NK) cells from MHC-I wild-type mice into MHC-Ideficient mice resulted in loss of NK cell responsiveness
The authors found that patients who lacked cognate ligands involved in NK cell licensing for the inhibitory killer-cell immunoglobulinlike receptors (KIR) in the donor had significantly worse disease free survival (DFS), overall survival (OS), and time to progression, compared with patients who had the ligands
Summary
Cord blood (CB) offers several unique advantages as a graft source for hematopoietic stem cell transplantation (HSCT). The risk of relapse and graft vs host disease after cord blood transplantation (CBT) is lower than what is typically observed after other graft sources with a similar degree of human leukocyte antigen mismatch. We highlight the uses of CB NK cells in transplantation and adoptive immunotherapy. We will review some of the obstacles we face in using resting CB NK cells for adoptive immunotherapy, and discuss methods to overcome them. We will review the current literature on killer-cell immunoglobulin-like receptors ligand mismatch and outcomes after CBT. We will touch on current strategies for the use of CB NK cells in cellular immunotherapy
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